Aivotoiminnan häiriöiden yhteydessä yleisesti koetut psykososiaaliset vaikeudet : PARADISE24-kyselyn tutkimusperusta

Ihmisen kokonaistilanne on tärkeä ottaa hoidossa ja kuntoutuksessa huomioon. Psychosocial Factors Relevant to Brain Disorders in Europa (PARADISE) -hanke toteutettiin kymmenen instituutin yhteistyössä professori Ciezan johdolla 2010–2013. Tavoitteena oli kehittää tutkimukseen perustuva menetelmä, jonka avulla voidaan kartoittaa psykososiaalisia vaikeuksia eri aivotoiminnan häiriöiden hoidossa, kuntoutuksessa ja tutkimisessa. Hankkeessa oli lähtökohtana oletus psykososiaalisten vaikeuksien horisontaalisesta epidemiologiasta. Hankkeessa tutkittiin yhdeksää aivotoiminnan häiriötä: dementiaa, depressiota, epilepsiaa, migreeniä, MS-tautia, Parkinsonin tautia, skitsofreniaa, aivoverenkiertohäiriötä ja päihderiippuvuutta. Kunkin häiriön osalta toteutettiin systemaattinen kirjallisuuskatsaus ja fokusryhmähaastattelu. Esiin nousseet psykososiaaliset vaikeudet luokiteltiin ja linkitettiin kansainväliseen toimintakykyluokitukseen (ICF). Eri häiriöille yhteisten 64 psykososiaalisen vaikeuden yleisyyttä ja intensiteettiä tutkittiin yksilöhaastatteluissa (n = 722). Tulosten pohjalta muodostettiin yleisiä psykososiaalisia vaikeuksia mahdollisimman laajasti kattava PARADISE24-kysely. Oletus eri häiriöiden yhteisistä psykososiaalisista ongelmista osoittautui todeksi. Kyselyyn valikoitui neljätoista kysymystä ICF:n osa-alueelta b Ruumiin/kehon toiminnot ja kymmenen kysymystä osa-alueelta d Suoritukset ja osallistuminen. Psykososiaalisten vaikeuksien intensiteetissä esiintyi kuitenkin häiriöiden välillä eroja siten, että psykiatristen tai päihdehäiriöiden takia haastatellut käyttivät laaja-alaisesti viisiportaista vastausvaihtoehtojen asteikkoa, mutta neurologisten häiriöiden yhteydessä kaksi- tai kolmeportainen asteikko vaikutti riittävältä. PARADISE24-kysely sisältää olennaiset kysymykset, mutta jatkotutkimusta tarvitaan erityisesti kyselyn toimivuudesta seurantakäytössä. Raportissa esitetään PARADISE24-kyselyn valmistamisen tutkimusperusta horisontaalisten tulosten sekä erikseen päihdehäiriöiden näkökulmasta.36,00 euro

Photoelectron recoil in CO in the x-ray region up to 7 keV

Carbon 1s photoelectron spectra of CO molecules in gas phase were recorded in the tender x-ray energy range, from 2.3 to 6.9 keV. The intensity ratios of individual peaks from ν=0 to 3 within the vibrational progression of the C 1s photoelectron spectrum were determined at the various photon energies and are shown to be strongly affected by the photoelectron recoil effect. The experimental vibrational intensity ratios are compared with theoretical predictions at different levels of accuracy. Developments of the recoil model, using generalized Franck-Condon factors, rovibrational coupling, Morse potential energy curves, and accurate angular averaging are presented and applied to the analysis of the experimental results

Photoelectron recoil in CO in the x-ray region up to 7 keV

Carbon 1s photoelectron spectra of CO molecules in gas phase were recorded in the tender x-ray energy range, from 2.3 to 6.9 keV. The intensity ratios of individual peaks from nu = 0 to 3 within the vibrational progression of the C 1s photoelectron spectrum were determined at the various photon energies and are shown to be strongly affected by the photoelectron recoil effect. The experimental vibrational intensity ratios are compared with theoretical predictions at different levels of accuracy. Developments of the recoil model, using generalized Franck-Condon factors, rovibrational coupling, Morse potential energy curves, and accurate angular averaging are presented and applied to the analysis of the experimental results

Health-related quality of life in alcohol dependence: a systematic literature review with a specific focus on the role of depression and other psychopathology

Background: Health-related quality of life (HRQOL) is considered a valid measure of treatment effectiveness in addictions. However, alcohol research has lagged behind other biomedical fields in using HRQOL outcomes as primary or secondary endpoints. Previous work has suggested that psychiatric co-morbidity may mediate the relationship between alcohol dependence and HRQOL. Aim: The goal was to summarize the literature on HRQOL and its domains in the context of alcohol dependence. A specific focus was on the impact of depression and other psychopathology on these areas of life. Materials and methods: A database search of MEDLINE and PsychINFO was performed within the scope of PARADISE (Psychosocial fActors Relevant to brAin DISorders in Europe); a European Commission funded coordination action. Using pre-defined eligibility criteria, 42 studies were identified. A systematic approach to data collection was employed. Results and conclusions: Alcohol dependence was shown to affect overall HRQOL and its domains, including general health, physical and mental health, general and social functioning, activities of daily living, pain and sleep. The evidence demonstrating that alcohol dependence is a primary cause of impairments in overall HRQOL, general health, mental and physical health and social functioning was fairly strong. Treatment interventions helped improve HRQOL and its aforementioned domains. The reduction or cessation of alcohol use facilitated these improvements; however, it was not reported to be predictive of improvement in all instances where improvement was reported. Depression was associated with further decreases in HRQOL. Personality disorders contributed to the severity of social functioning impairment<br/

Psychosocial difficulties in alcohol dependence: a systematic review of activity limitations and participation restrictions

Abstract Purpose: There has been a lack of comprehensive reviews targeting specific aspects of functioning and the difficulties faced by persons with alcohol dependence. The aim of the present review was to systematically compile the existing literature on activity limitations and participation restrictions as defined in the International Classification of Functioning, Disability and Health (ICF) in the context of alcohol dependence. Methods: A database search (MEDLINE and PsychINFO) was performed for studies published in English (2005-2012), examining the activity limitations and participation restrictions in alcohol dependence. Using a standardised protocol, information about the studies' characteristics and data on activity limitations and participation restrictions, their evolution, onset, determinants and associations with other variables were extracted from the studies under review. Results: A total of 211 difficulties in activities and participation in persons with alcohol dependence were extracted from 125 papers. The spectrum of studies was wide, and their overall quality was good. A common reason for the exclusion of studies was an inconclusive definition of alcohol dependence. Issues with interpersonal interactions, economic and professional life, dealing with aggression and legal problems were the most frequently reported difficulties. Problems with high-risk behaviours and in seeking appropriate treatment were also common. The most frequent determinants of the onset and evolution of the identified difficulties were factors pertaining to the course of alcohol dependence. These difficulties were rarely the studies' focus; therefore, the data on their underlying causes and courses were limited. Conclusions: The results confirm that alcohol dependence profoundly affects the family and social network of the afflicted person. The treatment of alcohol dependence can contribute to the alleviation of these associated difficulties. The ICF offers a new perspective on evaluating the wide range of difficulties encountered in the context of alcohol dependence. Implications for Rehabilitation Alcohol dependence profoundly affects the family and social network of the afflicted person. The most frequent difficulties in activities and participation have to do with interpersonal interactions, economic and work life, dealing with aggression and legal problems. Problems with high-risk behaviours and in seeking appropriate treatment are also common. Treatment targeted at reduction or cessation of alcohol use is effective in reducing these psychosocial difficulties. The ICF offers a structure for systematic evaluation of the wide range of difficulties encountered in alcohol dependence.<br/